中性粒细胞/淋巴细胞比值在原发性胆汁性肝硬化中的诊断意义分析

目的 研究中性粒细胞/淋巴细胞比值(NLR)在原发性胆汁性肝硬化(PBC)中的变化及其诊断价值.方法 收集PBC患者28例,慢性乙肝(CHB)患者50例,另收集健康体检者39例为正常对照组(HC组).所有患者抽取EDTA-K3抗凝血并分离血清,血液分析仪分析血液常规指标,全自动生化分析仪分析肝功能.利用Pearson和Spearman相关性和ROC曲线统计分析NLR在PBC中与其他指标的相关性及其诊断价值.结果 PBC组与CHB组比较NLR显著升高2.4(1.5～3.1)比1.6(1.4～2.1)],差异有统计学意义(P=0.002),同时高于HC组2.4(1.5～3.1)比1.4(1.1～1.8),P<0.001];PBC组NLR与红细胞平均分布宽度(RDW)呈显著正相关(r=0.50,P=0.007),与CHB组和HC组均无显著相关性(CHB:r=0.068,P=0.640;HC:r=-0.070,P=0.673).NLR在PBC-HC组的曲线下面积为0.760(0.636～0.883);CHB-HC组的曲线下面积为0.608(0.490～0.726);PBC-CHB组曲线下面积为0.680(0.547～0.813).结论 NLR在PBC患者中显著升高,且与RDW呈正相关关系,在PBC的诊断及其与CHB的鉴别诊断中具有重要的应用价值.

Diagnosis value of neutrophil-to-lymphocyte ratio in primary biliary cirrhosis

Objective To investigate the change of neutrophil-to-lymphocyte ratio (NLR) in primary cirrhosis and its diagnosis value. Methods 28 patients with primary biliary cirrhosis (PBC), 50 patients with chronic hepatitis B (CHB) and 39 health controls (HC)were involved in this study. EDTA-K3 anti-coagulated blood and serum were collected. Blood routine test and liver functions were assayed by hematology analyzer and automatic biochemistry analyzer. Spearman and ROC curve were employed to evaluate correlations between NLR and the other items and diagnosis value of NLR. Results NLR in PBC group was higher than that in CHB group 2.4(1.5-3.1) vs. 1.6(1.4-2.1), P=0.002]and HC group 2.4(1.5-3.1) vs. 1.4(1.1-1.8),P<0.001]. NLR was positively correlated with red blood cell distribution width(RDW) in PBC patients(r=0.50,P=0.007), and no correlation was found in CHB and HC group(CHB:r=0.068, P=0.640; HC:r=-0.070, P=0.673). Area under curves(AUC) were 0.760(0.636-0.883). 0.608(0.490-0.726) and 0.680(0.547-0.813) in PBC-HC, CHB-HC and PBC-CHB, respectively. Conclusions NLR was increased in patients with PBC and was positively correlated with RDW, which was of great importance in the diagnosis of PBC and differential diagnosis between PBC and CHB.